An Unusual Intracranial Metastasis of Osteosarcoma

顱內鈣化病灶可由多種疾病造成，如先天性疾患、代謝異常、炎性病灶、出血性疾患、出血性病灶及腫瘤等所引起，但由骨肉瘤引起則甚為罕見。本篇報告一例顱內巨大鈣化病灶，發現時合併有多處骨骼、縱隔腔、肋膜腔、副腎等病灶，以開顱手術取出腫塊，經病理切片診斷為骨肉瘤，但原發部位不明，本篇不考慮為 multifocal 之狀況，因為許多病灶皆非常見之原發部位，而且身體內的其他病灶，都有文獻分別報告為骨肉瘤的轉移部位，所以本病例應為早期血行性轉移的骨肉瘤，依 AmstutZ 的分類，為 Typelo 手術後病人症狀立即改善，之後並施行放射治療，但放射治療對此病例似乎效果不大，因為於術後五個月死亡，家屬拒做屍體剖檢。本篇把骨肉瘤有顱內轉移的文獻整理在 Tablel ，分為顱骨，硬膜外或硬膜，及腦內轉移三種，像本病例腫瘤長在硬膜下，壓迫腦表面，類似腦膜瘤的型態，尚無文獻陳述。

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並列摘要

Intracranial metastasis is unusual in osteosarcoma. A case of osteosarcoma was presented with a large intracranial “stone” which was a subdural convexity metastasis. Smaller epidural metastases over other areas were noted also in brain CT scan. Using the radiographs and bone scans, many other lesions at bones, the mediastinum, pleura, perirenaL space, and adrenal gland were detected simultaneously. This condition might result from either early metastases or multifocal osteosarcomas. Because many of the above lesion sites were not frequent locations of primary osteosarcoma and had been reported as metastatic targets of osteosarcoma. So the explanation of a very malignant osteosarcoma with early metastases may be more appropriate for this case. The baseball -like tumor in the subdural space with marked compression of the brain surface was grossly totally excised. Histopathologic examination confirmed the diagnosis of Osteosarcoma. Postoperatively, the man’s condition improved dramatically, though only for two months. He died 5 months later. Reports of such metastatic osteosarcomas are riviewed.

並列關鍵字

intracranial metastasis ； osteosaroma ； computed tomography

國際替代計量

An Unusual Intracranial Metastasis of Osteosarcoma

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